A study looking at pain after breast cancer surgery

The researchers found that chronic pain before surgery, the type of surgery  to the breast and the armpit, and being positive and optimistic can affect the pain you have shortly after breast cancer surgery. The researchers also plan to follow up the women in the study to learn more about how they recover in the months after surgery.

The study team asked 362 women to complete questionnaires before they had breast cancer surgery. These asked about their general health, how they were feeling and whether they had any painful conditions before surgery.

Before surgery, more than 4 out of 10 (42%) of the women reported having some pain, discomfort, altered sensation or numbness in the upper part of their body. A high proportion of symptoms were thought to be from tests before surgery such as biopsies . Fewer than 1 in 5 (16%) women had painful symptoms that had lasted for more than 3 months (chronic pain) before they had their surgery.

All the women in the study had a wide local excision, a mastectomy or a mastectomy with breast reconstruction. During surgery, just over 4 out of 10 women had between 1 and 3 lymph nodes assessed (sentinel lymph node biopsy). But more than half the women had 4 or more lymph nodes removed (an axillary node sample or axillary clearance).

The study team phoned 338 of the women within 10 days of having surgery. They asked about pain they’d had after surgery when resting and pain that was brought on by movement. More than 9 out of 10 women reported having some pain at rest in the 1st week after surgery.

The women were asked to rate pain on a scale of 0 to 10 where 0 is no pain and 10 is the worst pain imaginable. Researchers considered a score higher than 4 as being moderate to severe pain. Half the women (50%) said they’d had moderate to severe pain brought on by movement in the 1st week after surgery. Over half (54%) had taken painkillers in the last 24 hours.

The researchers found that women who had a sentinel lymph node biopsy were less likely to have pain in the 1st week after surgery than women who had 4 or more lymph nodes removed.

An important finding was that women who had chronic pain before surgery were 3 times more likely to have pain when moving after surgery.

In this study, women who were more anxious, worried or depressed according to the questionnaire they completed before surgery had more pain in the week after surgery. By looking at a number of mental health factors assessed in the questionnaires, the study team found that women who were more optimistic and had a positive outlook were likely to have less pain after surgery.

We have based this summary on information from the team who ran the study. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.